{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:41:16Z","timestamp":1792197676639,"version":"4.4.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To determine whether nail plate constructs have lower rates of reoperation to promote bone healing than lateral locking plates in the treatment of distal femur fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single Level 1 trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants:<\/jats:title>\n                    <jats:p>Three hundred twelve consecutive patients treated operatively for native distal femur fractures (OTA\/AO 33A or 33C).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>Reduction and fixation of distal femur fractures with a lateral locked plate (LLP) or a nail + plate construct (NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measurements:<\/jats:title>\n                    <jats:p>Reoperation to promote bone healing at any time after definitive fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Two hundred seventy-nine fractures were treated with LLP and were compared with 33 fractures treated with NPC constructs. Patient demographics, injury severity score, and frequency utilization of each construct between different types of OTA\/AO-classified distal femur fractures were similar. The reoperation rate to promote bone healing was 18.7% (51\/273) for LLPs, and 3% (1\/33) for NPC constructs. There was no significant difference in surgical site infection (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.67).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Utilization of NPC technique demonstrated a significant decrease in rates of reoperation to promote bone healing compared with LLP alone in the treatment of OTA\/AO 33A and 33C distal femur fractures. Augmented fixation with NPCs should be considered to treat complex distal femur fractures, because it is associated with lower rates of reoperation to promote bone healing in comparison to LLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000002708","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:40:37Z","timestamp":1695775237000},"page":"621-626","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Nail Plate Constructs are Associated With Decreased Rates of Reoperation in Complex Distal Femur Fractures"],"prefix":"10.1097","volume":"37","author":[{"given":"Alexander","family":"Roszman","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Cone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Chodaba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Cichos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"McGwin","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Medical Center, Birmingham, AL; and"},{"name":"Department of Epidemiology, UAB School of Public Health, Birmingham, AL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clay","family":"Spitler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.injury.2013.10.042","article-title":"Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures","volume":"45","author":"Rodriguez","year":"2014","journal-title":"Injury"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ocl.2015.08.011","article-title":"Management of distal femur fractures in adults: an overview of options","volume":"47","author":"Gangavalli","year":"2016","journal-title":"Orthop Clin North Am"},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s00402-020-03463-x","article-title":"Incidence of nonunion after surgery of distal femoral fractures using contemporary fixation device: a meta-analysis","volume":"141","author":"Yoon","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/00005131-200605000-00013","article-title":"Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005)","volume":"20","author":"Zlowodzki","year":"2006","journal-title":"J Orthop Trauma"},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"2675","DOI":"10.1007\/s00264-018-3864-4","article-title":"Healing, nonunion, and re-operation after internal fixation of diaphyseal and distal femoral fractures: a systematic review and meta-analysis","volume":"42","author":"Koso","year":"2018","journal-title":"Int Orthop"},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1749-799X-8-43","article-title":"Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort","volume":"8","author":"Hoffmann","year":"2013","journal-title":"J Orthop Surg Res"},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/BOT.0000000000000593","article-title":"Mechanical construct characteristics predisposing to non-union after locked lateral plating of distal femur fractures","volume":"30","author":"Rodriguez","year":"2016","journal-title":"J Orthop Trauma"},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/BOT.0b013e31829e6dd0","article-title":"Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases","volume":"28","author":"Ricci","year":"2014","journal-title":"J Orthop Trauma"},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1302\/0301-620X.98B6.36826","article-title":"Nails or plates for fracture of the distal femur? 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